Dr Shreya N. Padiyar
As the name suggests ‘Iron Deficiency Anemia’ is a type of anemia caused by lack of iron, it is the decrease in the number of red blood cells or the amount of hemoglobin in the blood.
It is the most common nutritional disorder in the world. It is commonly seen in toddlers, adolescent girls, and women of childbearing age. The total body iron in a 70 kg man is about 4gm. This iron balance is maintained largely by regulating the iron absorption of dietary iron and body losses. Usually females have smaller stores of iron when compared to males due to blood loss during menstruation. The daily iron requirement is 7-10 mg in men & 7-20 mg in women.
- Dietary lack of iron: in such cases infants are at high risk because milk diets contain very small amounts of iron.
- Impaired absorption: occurs in cases of sprue, intestinal steatorrhea, chronic diarrhea, gastrectomy…
- Increased requirement: this is an important cause of iron deficiency anemia as it is commonly seen in infants, children, adolescents, premenopausal and pregnant women.
- Chronic blood loss: as can be seen in conditions like peptic ulcer, uterine fibroids, HIV/ AIDS, Malaria, worm infestations ( pinworm/hookworm diseases) …
- Due to decreased iron supply there will be impaired Hb synthesis. This leads to a generalized defect in cellular proliferation, when anemia becomes severe there will be reduced erythrocyte survival.
- When transferrin saturation falls below 16%, the supply of iron to the marrow becomes inadequate for Hb production, leading to increased protoporphyrin which hampers heme synthesis leading to microcytic and hypochromic anemia.
- Because of restricted cellular proliferation and fall in number of RBCs there will be erythroid hyperplasia which caused ineffective erythropoiesis and the immature erythroid cells will be rapidly destroyed in spleen shortening the survival rates.
- Anemia only appears when iron stores are completely depleted, accompanied by low serum iron, serum ferritin and transferrin saturation. Thus, the reduced erythrocyte viability is associated with decreased membrane deformability. This abnormality appears to result from oxidative damage to the membrane.
SIGNS AND SYMPTOMS:
- Fatigue and diminished capability to perform hard labour.
- Leg cramps on climbing stairs.
- PICA especially for ice to suck or to chew.
- Poor scholastic performance.
- Decreased immunity.
- Impaired growth in infants.
- Irritability, headache, palpitations, dizziness, breathlessness.
ON PHYSICAL EXAMINATION:
- Pallor of the mucous membranes
- Koilonychia i.e. spoon shaped nails.
- Glossy tongue with atrophy of lingual papillae, angular stomatitis…
- Complete blood count
- Peripheral blood smear
- Serum iron levels, serum ferritin levels, and TIBC (total iron binding capacity).
One can treat iron deficiency anemia homoeopathically by giving constitutional remedy, below mentioned are a few remedies which can be given for this condition:-
- China officinalis: This remedy has debility from exhausting discharges and loss of vital fluids. The individuals will have sallow complexion of face especially after hemorrhage, loss of vital fluids or sexual excesses. There will be heaviness of head with loss of sight, aversion to exercise, sensitive to touch, ringing sensation in ears, intolerance to fruits. Great congestion in the chest and violent palpitation of the heart. Trembling with numb sensation.
- Ferrum metallicum: This remedy is best suited for young weakly persons, who are anemic with pseudoplethora, who flush easily, have cold extremities, oversensitive to slight noises and whose complaints become worse after any active effort. There is weakness from mere speaking or walking. Red parts become white, bloodless and puffy. There will be breathing difficulty due to surging of blood to chest and anemic murmur can be heard.
- Sepia: Here women will have a weak yellow complexion. They feel cold even in a warm room. They are irritable. There will be asthenic inflammation of eye with uterine trouble. There is craving for vinegar, acids and pickles. Dyspnea aggravates after sleep and is better by rapid motion. Violent intermittent palpitation.
- Phosphorus: This remedy is adapted to tall, slender persons, narrow chested, thin with transparent skin, weakened by loss of animal fluids. There will be great debility with emaciation. There will be hemorrhagic tendency. Chronic congestion of head, thirst for cold water. Violent palpitation with anxiety while lying on left side and weakness and trembling from every exertion.
- Lecithinum: This remedy has action on blood and is usually given for anemic individuals to increase the number of RBCs and amount of Hb. There will be mental exhaustion. The individual will be weak with shortness of breath, loss of flesh, will be forgetful, dull and confused. The headache in the occiput will be pulsating type and will crave for wine and coffee.
REPERTORIAL APPROACH FOR ANEMIA:
ANEMIA,hæmorrhage, after : Calc., carb-v., Chin., Ferr., lach., nat-m., nux-v., ph-ac., phos., sulph.
ANEMIA- from different causes
Chlorosis — Acet. ac., Alet., Alum., Arg. n., Arg. oxy., Arn., Ars., Aur. ars., Bism., Calc. ars., Calc. c., Calc. lact., Calc. p., Calop., Carbo v., Chin. ars., Chin. s., Cic., Cinch., Con., Crat., Crot., Cupr. ars., Cupr. m., Cycl., Ferr. ac., Ferr. ars., Ferr. carb., Ferr. et. chin., Ferr. p., Ferr. iod., Ferr. m., Ferr. mur., Ferr. oxy., Ferr. red., Gossyp., Graph., Helon., Hydr., Iod., Irid., Kali bich., Kali c., Kali p., Lecith., Lyc., Mang. ac., Merc. s., Nat. c., Nat. m., Nit. ac., Nux v., Petrol., Phos., Phyt., Picr. ac., Plat., Plumb. ac., Puls., Rubia., Sacchar. of., Sec., Sep., Sil., Strych. et ferr. cit., Sul., Thyr., Vanad., Zinc. ars., Zinc. mur.
Cardiac disease [from] — Ars., Crat., Stroph.
Grief [from] — Nat. m., Phos. ac.
Malaria [from] — Alston., Ars., Nat. m., Ostrya, Robin.
Menstrual derangements [from] — Arg. oxy., Ars., Calc. c., Calc. p., Crat., Cycl., Ferr., Graph., Kali c., Mang. ac., Nat. m., Puls., Sep.
Nutritional disturbances [from] — Alet., Alum., Calc. p., Ferr., Helon., Nux. v.
Suboxidation [from] — Picr. ac.
Syphilis [from] — Calop.
Vital drains, exhausting disease [from] — Acet. ac., Alston., Calc. p., Chin. s., Cinch., Ferr., Helon., Kali c., Nat. m., Phos ac., Phos.
Hæmorrhagic — Arg. oxy., Ars., Calc. c., Crot., Ign., Nat. br.
Pernicious anemia — Ars., Phos., Picr. ac., Thyr.
Erythistic; worse in winter — Ferr. m.
- Robbins and Cotran Pathologic Basis Of Disease, 7th edition, pg 643-646, Elsevier publication.
- Wintrobe’s Clinical Hematology, Greer J.P, Foerster J. et al,11th edition, pg 988-989, Lippincott Williams & Wilkins publication.
- Iron deficiency anemia, emedicine.medscape.com, https://emedicine.medscape.com/article/202333-overview
- Iron deficiency anemia, Wikipedia.com, https://en.wikipedia.org/wiki/Iron-deficiency_anemia
- Boericke’s New Manual Of Homoeopathic Materia Medica With Repertory, William Boericke, B.Jain publishers.
- Homoeopathic Therapeutics The Classical Therapeutic Hints, Samuel Lilienthal, page 27-28, B. Jain publishers.
- Synthesis repertory- 8.1 version
- Boenninghausen’s Therapeutic pocket book
- Boenninghausen’s Characteristic Materia Medica and Repertory by Dr. C.M.Boger
- 10)Therapeutic pointers- some common diseases-Dr. E.A.Farrington
- 11)Homoeopathic medical repertory by Dr. Robin Murphy
By Dr Shreya N. Padiyar, Bhms, Md Part 1
(Organon Of Medicine & Homoeopathic Philosophy)
Under The Guidance Of Dr Shivaprasad K., Hod Of Organon Of Medicine & Principal Of Father Muller Homoeopathic Medical College And Hospital.